An April 23 letter writer begged: “Can someone please enlighten me?” He wanted to know what was preventing another letter writer’s 30-year-old son from getting medical insurance before the Affordable Care Act.

As most people who followed the debate over the ACA know, the answer in such situations often is a pre-existing condition. My son had a serious medical condition treated with major surgery when he graduated from high school under my employer’s medical plan. The plan continued to pay for the required annual follow-ups until he graduated from college. Then he looked everywhere to get an insurance policy to cover all his medical needs, but it was impossible — all insurance companies rejected his pre-existing condition, so he had to pay for the necessary treatments himself for the next 20 years.

Now, however, he has a new policy that completely covers his medical needs. The government isn’t providing him a handout for something he is working to pay for, but it is assuring him the opportunity to get the coverage he had been denied for years. I hope that the reader has been enlightened that in the real world the things he imagined as being available aren’t there, at least not for some people who need them.

Roger Nelson, Woodbury

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I read with amazement a separate April 23 letter in which the writer was not buying the latest projection from the Congressional Budget Office of the ACA’s costs. First, CBO projections are not politically biased, since the study was not conducted or paid for by any political party. Next, the study was a 10-year projection, and credibility is added when an extended projection is updated with more accurate and additional data, such as learning that premiums were lower than anticipated, leading to lower government subsidies. I might project that the study will be updated again in the future, up or down. It will still be based on the best available data.

The real question is, what will be the impact of the ACA? There has already been some impact. For example, FactChecker.org reported on Feb. 14 that annual per capita health care costs had increased about 3 percent for each of the past three years. Over the previous eight years, per capita health care costs increased about 8 percent per year. FactChecker attributes part of the lower recent increases to the ACA and part to the economy. It should be noted that the economy was in free fall during some of the “8 percent” years.

The cost of ACA plans will decrease further as the plans’ provisions are implemented, such as adding preventive care, adding coverage for (and premiums from) the previously uninsured, and reducing medical errors, waste and fraud.

Jerome Skrupky, Shakopee

METROPOLITAN COUNCIL

Planners have the wrong outcome in mind

Why plan for growth? The Metropolitan Council should be planning for sustainability (“Growth forecast brings conflict as cities vie for development dollars,” April 23). The emerging reality is that our seven-county metropolitan region will face unprecedented challenges in the not-too-distant future. These social, economic and ecological realities, driven by limits imposed by changes in water and energy, will necessitate transformative changes. We must become a different kind of country. We should be planning transitions required over the next five years, not projecting growth over the next 30.

Face facts: Uncontrolled economic growth is unsustainable on a finite planet. Signs of stress are becoming apparent everywhere as a consequence of climate disruption and peaking of vital natural resources, particularly water and oil. If anyone has doubts, visit local grocery markets and compare rising prices for fruit, vegetables, meat and fish due to prolonged droughts and transportation costs from producing regions. It doesn’t make sense to pave over productive land in proximity to where people live. City dwellers need to be aware that the average distance our food travels from field to fork exceeds 1,500 miles and consumes 100 calories of energy to produce 10 calories of nourishment.

We need to be mindful that the future is not what it used to be. One of Earth Day’s messages was “business as usual” must come to an end soon if we hope to ensure a habitable planet.

David L. Trauger, Marine on Saint Croix

CATHOLIC CHURCH

A better explanation for clergy abuse

Pat Ferguson Hanson (“… A window into the culture that protected pedophile priests,” April 23) attempts to blame the prevalence of pedophilia in the Roman Catholic clergy on gay men attracted to the priesthood as cover, who then somehow become pedophiles under the stress of self-denied sex. This seems implausible to me. Much more plausible is that the priesthood disproportionately attracts men who are already pedophiles, at least in tendency, and who also want a reasonable cover for their lack of adult sexual relationships along with trusted access to children. This would result in a higher prevalence of pedophiles without the added supposition of sex denial leading to pedophilia.

Tim Church, St. Paul

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The April 23 commentary offered a seemingly rational explanation underlying sexual abuse of children by priests with the insight of 60 years as a Catholic. Unfortunately the author closed with the assertion that church administrators have learned an “expensive lesson” that “laws are meant to be kept” and “courts do exact their pound of flesh.” I fail to see that and wish that it were true.

Bob Reid, Bloomington

PROGRESSIVE MAYORS

An experiment that will swiftly play itself out

Harold Meyerson seems quite pleased with mayors such as Minneapolis’s Betsy Hodges and New York’s Bill de Blasio (“Big cities ride a new progressive wave,” April 25). With any luck, their policies will have these cities just like Detroit in no time at all.

Dave Remes, Northfield

MINIMUM WAGE

Ultimately, some will be harmed by increase

I think that everyone agrees that we need to help hardworking individuals stuck in low-paying jobs. Gail Rosenblum, in her April 24 column “A realistic view of the minimum wage hike,” did a nice job highlighting two individuals who will be helped by the new law. However, as Milton Friedman said, “The minimum wage law is most properly described as a law saying that employers must discriminate against people who have low skills.” I wonder whether we will also see a story about people who find that the wage has priced them and their limited job skills out of the labor market.